We Must Discourage Medical Use of Opioids and Marijuana—for the Children

The results from the 2011 National Survey on Drug Use and Health (NSDUH), released this week, are not very different from the 2010 results. Reaching for evidence of success in the war on drugs,  the federal government is highlighting a 14 percent drop in the number of 18-to-25-year-olds who reported using prescription drugs for nonmedical purposes in the 30 days prior to the survey. USA Today notes that the change occurred "amid federal and state crackdowns on drug-seeking patients and over-prescribing doctors." Pamela Hyde, who runs the agency (the Substance Abuse and Mental Health Services Administration) that sponsors the survey, says "these findings show that national efforts to address the problem of prescription drug misuse may be beginning to bear fruit and we must continue to apply this pressure to drive down this and other forms of substance use." Here are three reasons to be skeptical of this argument:

1. If nonmedical use of prescription drugs had stayed the same or gone up, Hyde still would be arguing that her numbers show the need for continued "pressure to drive down this and other forms of substance use." That's the great thing about drug use surveys: No matter what the data are, they always reinforce the case for more taxpayer money.

2. The government tends to notice drug trends, such as the increase in methamphetamine use during the 1990s or the increase in nonmedical use of prescription painkillers during the first decade of this century, after they have already peaked. That may seem like a disadvantage from the perspective of someone who counts on the government to stop people from consuming politically incorrect chemicals, but it positions government officials to take credit for declines in drug use that would have happened with or without their belated interventions.

3. To the extent that the "pressure" championed by Hyde works, it does so by discouraging doctors from prescribing opioids, which may seem like a great idea to drug warriors but is apt to be perceived differently by patients suffering from severe chronic pain who rely on these medications to make their lives livable. Since there is no way to objectively verify pain, even the most diligent physician has to put a certain amount of trust in his patient when deciding what to prescribe. Efforts to discourage doctors from believing their patients may well frustrate some malingerers, but only at the cost of condemning others to avoidable agony. It is hard to see how this tradeoff, which sacrifices the welfare of legitimate patients for the sake of protecting fakers from their own recklessness, can be morally justified.

Drug czar Gil Kerlikowske provides another illustration of how any data can be used to support any point a prohibitionist wants to make. The NSDUH report says the share of 12-to-17-year-olds reporting past-month marijuana use in 2011 (7.9 percent) was "similar to the rates in 2009 and 2010" (7.4 percent in both years). Kerlikowske nevertheless latches on to the new number as an excuse to reiterate his argument that legalizing marijuana for medical use and talking about legalizing it for recreational use send "a bad message" to the youth of America, encouraging them to believe cannabis is not all that dangerous (which happens to be true, but never mind) and tempting ambivalent teenagers to try it. "Marijuana is still bad news," he tells USA Today. "I think [teenagers] are getting a bad message on marijuana. I think that the message that it's medicine and should be legalized is a bad message."

Is there any evidence this "bad message" translates into more marijuana consumption by teenagers? Kerlikowske seems to be fixated on a single data point: The NSDUH measured a statistically significant increase in past-month use by 12-to-17-year-olds between 2008 and 2009 (from 6.7 percent to 7.4 percent). The timing suggests Kerlikowske himself may be to blame, since he took over the Office of National Drug Control Policy in early 2009. Not surprisingly, that is not the explanation he favors, but it makes at least as much sense.

NSDUH numbers indicate that the share of teenagers reporting past-month use of marijuana was slightly lower last year than it was in 2002, the first year of the survey, despite all the intervening publicity attracted by the marijuana reform movement. The Monitoring the Future Study, which focuses on students, indicates that the share of seniors reporting past-month marijuana use rose from 21.9 percent in 1996, the year that California became the first state to legalize the medical use of marijuana, to 23.7 percent in 1997. But the rate immediately started falling, and it has never been that high since, even as 16 more states and the District of Columbia followed California's example. Furthermore, studies that compare marijuana consumption in states with and without medical marijuana laws find no impact on use by teenagers. And if public receptiveness to repealing marijuana prohibition encourages teenagers to smoke pot, what are we to make of the fact that past-month use by 12th-graders peaked at 37 percent in 1978, even though the percentage of Americans favoring legalization has almost doubled since then? Kerlikowske's persistent reliance on this argument, despite all the evidence against it, should be condemned for what it is: a crude, fact-free attempt to intimidate reformers by portraying their advocacy as an act of child endangerment.

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  • sarcasmic||

    Fewer children are using drugs! The Drug War is a success! More funding now!

    More children are using drugs! We're not trying hard enough! More funding now!

  • Lost_In_Translation||

    Is that a pattern I see or are you just sending a SWAT team to kill me dog?

  • The Hammer||

    it positions government officials to take credit for declines in drug use that would have happened with or without their belated interventions.

    See also: OSHA and workplace injury declines, EPA and smog declines, myriad other government "success" stories.

  • BarryD||

    I started high school in 1980. We didn't smoke weed because it wasn't the hip thing to do, like it was in the 1970s. We also made fun of disco and called guys names for having long hair.

    None of that had a damned thing to do with government -- not the decline in how cool it was to smoke pot, nor shorter haircuts, nor the decline of knee socks on men, nor the rise of New Wave music and the resurgence of the Ray Ban Wayfarer.

  • Almanian's Evil Twin||

    I graduated HS in 1980. I smoked a SHITLOAD of weed in HS (but never drank but once), had long hair (that a couple guys on the track team made fun of, but most didn't, cause they had long hair, too), definitely experienced the transition to shorter athletic socks from the knee highs, didn't have a lot to do with the New Wave (Who, Stones, Zep, Aerosmith, etc for me)...and STILL wear nothing but Ray Bans for my shades (prescription, doncha know).

    Ya nailed it, dude. Well done!

  • BarryD||

    ...and when pot and hair bands came back into vogue some years later, the government had nothing to do with that, either... :)

  • BarryD||

    Oh yeah, and we drank whatever we could get our hands on...

  • Almanian's Evil Twin||

    Yep. I'd go back to HS or college tomorrow - LOVED it!

  • Delroy||

    I bet you tied your long hair into a ponytail, didn't you?

    You know why men with long hair tie their hair into ponytails? Because they look too weird when they tie it up into pigtails!

  • amelia||

    I also started high school in 1980. I didn't smoke it because I wasn't interested (that happened in college). I do remember the shift in public rhetoric about pot from the '70s to the "Just Say No" era. I didn't really realize it was coming from the federal level, but I definitely noticed that something I once thought people saw as benign suddenly wasn't being treated that way anymore. I was puzzled.

  • ||

    With President Obama expressing his disappointment with the replacement officiating and poor officiating being the lead story of network news coverage, NFL commissioner Roger Goodell had to act -- and he did.

    http://espn.go.com/nfl/story/_.....feree-deal

  • The Hammer||

    Obama's next campaign ad: Bin Laden is dead, the NFL refs are back to work, 4 more years!!!!

  • amelia||

    Shut up. This is important stuff.

  • Zeb||

    7.9% of 12-17 year olds seems pretty low to me. If it is true, I'd think the drugwarriors would think it a good thing (no, it probably just means we have to do more of whatever we have been doing). I remember, in around 1990, doing a count of the people in my 8th grade class (total of about 120 kids) who I knew smoked weed and it was about 10%. And that was 13-14 year olds.

  • sarcasmic||

    In 1990 when they were passing around those surveys at my high school I don't know anyone, including myself, who filled them out honestly.

  • Zeb||

    Would you say people under reported or over? I think I actually answered pretty honestly with those things because I wanted to be part of their statistics as a straight A student who tried pretty much whatever drugs were available.

  • sarcasmic||

    Would you say people under reported or over?

    Both. Some of us didn't trust that the surveys were really anonymous, while others thought it would be fun to screw with the statistics.

  • James Sinclair||

    I would assume that under-reporting has always been a bigger problem than over-reporting, and that as marijuana has become less stigmatized, the numbers have become more accurate. But I'm just guessing. Has anyone figured out a way to study this?

    (I'm imagining a survey with a bunch of drug questions, then a bunch of unrelated questions, and then the drug questions again, except prefaced with "no, seriously, we want you to be honest with us...")

  • kinnath||

    If the government wanted to end drug use amongst children, it would give public schools the repsonsibility to teach them how to use drugs. Given the school's past successes in teaching kids to read and write, drug use could be wiped out in a generation.

  • ||

    lol, awesome.

    Charter school kids would be left to continue the responsible use of drugs. Need someone to make rock and art and all that....

  • BakedPenguin||

    I had a similar thought - if the government really wanted people to not use drugs, it should take over their manufacture, distribution, and marketing.

  • ||

    considering i'm staring at a bunch of these post surgery dilaudids , maybe i should refrain from comment...

    oh wait

    FUCK YOU KERLIKOWSKE, YOU STUPID COP-O-CRAT.

  • nicole||

    Dilaudid is the best thing ever. Hope you're not in too much pain to enjoy it.

  • Ayn Random Variation||

    Fuck the children.

    -George Carlin

  • ENDelt260||

    Is there time?

    -The priest in that crashing airplane joke

  • Almanian's Evil Twin||

    *Roman Polanski's ears perk up*

  • Tim||

    Ai chihuaha! That Palin stripper has a nice smile.

  • BarryD||

    What gets lost in the idea of people "favoring legalization" is that things weren't always illegal. The status quo is arbitrary.

    People favor not throwing people in jail because they smoke, grow, or trade in marijuana.

    It's not that people favor legalizing something that has always been illegal or is somehow accepted to be morally wrong like burglary. It hasn't and it isn't. It's that people favor just backing off and letting people do what they want when they're not hurting anyone.

  • R C Dean||

    I'd think the pro-potters would be smart to start using the term "re-legalize marijuana."

  • buybuydandavis||

    "End Marijuana Prohibition"?

  • Lost_In_Translation||

    no shit...

  • sarcasmic||

    is somehow accepted to be morally wrong like burglary

    You'd be surprised at how many people really do consider all drug use, including marijuana, to be immoral (as they pop an anti-depressant and an opioid pain killer).

  • Almanian's Evil Twin||

    Drugs are bad, mm'kay?

  • ||

    These venal fucks are absolute pure evil. I hope each and every one of them develops severe chronic back pain and can't get a doctor to prescribe them opioids.

  • ||

    That's the thing. Drug warriors are actively, aggressively malignant. They want to cause suffering. And they do it under the cloak of saving people. It's like an entire generation of Mother Teresas.

  • sarcasmic||

    It's a morality thing.
    Drug use is wrong.
    Drug users are bad people.
    It is a drug warriors moral duty to punish them, then kick back on prescription pain meds after he hurts himself breaking down a door and shooting someone's dog.

  • ||

    Right, like I said: actively, aggressively malignant.

  • Paul.||

    Back pain is for little people.

  • Paul.||

    Like Courtney Love, Kerlikowske isn't just Seattle's problem anymore...

  • buybuydandavis||

    " highlighting a 14 percent drop in the number of 18-to-25-year-olds who reported using prescription drugs for nonmedical purposes in the 30 days prior to the survey. "

    I wonder if that was made up for by the number using prescription drugs for "medical" purposes.

    People seem happy to pump kids full of ADHD drugs every day, but if they occasionally get high, that's a horrible tragedy.

  • sarcasmic||

    Immoral people seek pleasure via illicit chemicals.

    Moral people seek pleasure via a natural adrenaline rush as they bust down doors, kill family pets, and terrorize children.

  • jway||

    American taxpayers are being forced to pay $40 Billion a year for a prohibition that causes 10,000 brutal murders 800,000 needless arrests each year, but which doesn't even stop CHILDREN getting marijuana.

    After seventy years of prohibition, it's obvious that the federal marijuana prohibition causes FAR more harm than good and must END! Drug Dealers Don't Card, Supermarkets Do.

  • tarran||

  • Paul.||

    See, Katy Perry does cause violence!

  • ||

    "...cops believe Johnny was on drugs-- either PCP or meth -- at the time..."

    Based on what? The same basis that the cops believed the miami cannibal was on bath salts? And hey, what about bath salts? Are they out of style as a demon scapegoat already? We are back to PCP? I guess sooner or later everything comes back into fashion.

  • ||

    the dangers of PCP are not cop invented. PCP is just a very very rarely used drug. we had a poster here a ways back, iirc, a ER doc who had some choice and correct things to say about PCP. there is no equivocation in the medical literature either. the reason PCP is so rarely in the news is that it is such a rare drug. if it was used anywhere near as commonly as other street drugs, we would have some serious fuckupedness in the news about the shit people were doing on it

  • ||

    That wasnt exactly my point.

    I was mocking the efforts of these cops to demonize a particular substance as being responsible for this guy's behavior.

    Other than superficial observations the cops had no basis for concluding that that drug or any other was involved. He just pulled the PCP thing out of his ass.

    We should base our conclusions on the tox reports, not this guy's wild ass guess.

  • ||

    7.9% of 12-17 year olds seems pretty low to me.

    Those numbers seem to be utter nonsense. I'd say from the kids I know that the majority -- possibly a overwhelming majority -- of teens smoke weed at least occasionally.

  • Rich||

    National Survey on Drug Use and Health (NSDUH)

    How come the geniuses who came up with the *PATRIOT* Act can't do better than that acronym? Win The Future!

  • ||

    I'd put Gil in the top 5 worst things about the Obama administration. Maybe top 3, after The Man himself and Eric Holder.

  • ||

    Geez you are just skimming the surface of a very deep cesspool there. Five mins googling and I could name 100 of the top 5 worst things about captain zero's team.

  • ||

    i hope the ghost of kris kime haunts kerlikowse every minute of every day of his miserable life. kris kime, a man trying to help a woman who had been assaulted by a bunch of rapists and riotous thugs in Seattle. Kris Kime died, in brief, because the police did nothing to stop the rioting. Why? because they were ordered to. Kerlikowske is the worst kind of cop-o-crat.

    ---
    the infamous drug-infested Seattle Mardi Gras riots broke out, in which marauders brutally attacked revelers. They sexually assaulted a number of women, injuring 72 people in all. And they ultimately killed 20-year-old Kris Kime who was attempting to defend one of the assaulted women. During the height of the riots, Kerlikowske instructed police to not intervene, but rather to simply enclose the rioters and establish a perimeter for three whole hours.

  • ||

    Instead of taking action to interdict the riots, he opted only to contain them, ordering his troops to ignore pleas for help and allowing the mayhem to continue unabated. His excuse: He said he didn't want to add to the violence, according to the Seattle Post-Intelligencer.

    Sgt. Daniel Beste later sent a letter of apology to Kris Kimes' mother, saying "we also were aware of the rising tide of violence long before your son was killed and continually asked, 'Why don't we stop this?' Unfortunately, my question was never answered." Sgt. Beste also enclosed the $200 he had received for the "amount of overtime I was paid by the taxpayers of this city to stand by while they were beaten and your son killed." The $200 was later used to help pay for Kris Kimes' last hours, spent on a life-support system.

    Following the Mardi Gras tragedy, the city government announced that the actions (or, lack of the same) taken by police were unwise and had put the city at risk. Eventually, as a direct result of Kerlikowske’s order to his troops to stand down, the city of Seattle was forced to settle with the family of the murdered youth, giving them $2 million as restitution.

    ---

  • amelia||

    Fucking appalling. Why didn't this end his career? Or is that a pointless question?

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